Walter Matkiwsky, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MB02410900 Issued in NJ

Practice address

100 Hollywood Ave
Hillside Family Practice
Hillside, NJ 07205

Phone

(908) 353-7949

Fax

(908) 353-8374

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Philadelphia College of Osteopathic Medicine, 1969

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Morristown Medical Center Hospital, Morristown, NJ, CCN 310015
• Overlook Medical Center Hospital, Summit, NJ, CCN 310051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Practice Associates Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385

  Family Medicine

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Morristown, NJ
  • NPI 1053384776
  Care Compare affiliation
• Ahs Hospital Corp.

  • General Acute Care Hospital
  • Summit, NJ
  • NPI 1740254143
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1699789461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOLLYWOOD AVE",
            "address_2": "HILLSIDE FAMILY PRACTICE",
            "city": "HILLSIDE",
            "state": "NJ",
            "postal_code": "07205",
            "telephone_number": "908-353-7949",
            "fax_number": "908-353-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATKIWSKY",
        "first_name": "WALTER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB02410900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2195704",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medvale Home Care LLC
• Rebecca Micial
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• Family Medicine Physician in Hillside, NJ
• Providers in Hillside, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.